Individual provider Active NPI

George Alfred Leboeuf III, LCSW, LMT

  • Clinical Social Worker
  • Sandy, UT
National Provider Identifier
1194560615
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13946847-3501 Issued in UT
Practice address
57 W 9000 S Ste 104
Sandy, UT 84070-2008
Phone
(385) 722-4431
NPI assigned
Jun 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2025-1293 NM
Clinical Social Worker 1041C0700X 16063 CT
Clinical Social Worker 1041C0700X 13946847-3501 UT Primary
Massage Therapist 225700000X 13946847-4701 UT

Addresses

Primary practice location

57 W 9000 S Ste 104
Sandy, UT 84070-2008

Mailing address

57 W 9000 S # 104
Sandy, UT 84070-2008
Phone (385) 722-4431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16063CTMDClinical Social Worker
SWB-2025-1293NMMDClinical Social Worker
13946847-3501UTMDClinical Social Worker
13946847-4701UTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Stability LLC Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1194560615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 W 9000 S # 104",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702008",
            "telephone_number": "385-722-4431",
            "fax_number": "844-835-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W 9000 S STE 104",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702008",
            "telephone_number": "385-722-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBOEUF",
        "first_name": "GEORGE",
        "middle_name": "ALFRED",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW, LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-26",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2025-1293",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "16063",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "13946847-3501",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "UT",
            "license": "13946847-4701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.